Clinical Appeication Value Of Evaluation Liver Fibrosis Stage By Contrast Enhanced Ultrasound And Serum Fibrotic Markers

Objective Accordinng to the liver histopathology, to study liver blood flow imaging afterintradermal injection of microbubbles and the secrum fibrotic markers of patients withliver fibrosis, to investigate the clinical application value of evaluating the liver fibrosisby them and to fliter the close parameters.Methods The study included38patients with chronic hepatitis B and8healthy controls.After two-dimensional and color Doppler ultrasonography, bolus of ultrasound contrastagent was injected through cubital under the mode of contrast pluse sequence imaging.Meanwhile built-in timer of the ultrasonic diagnostic apparatus was started. The bloodflow imaging of hepatic artery, portal vein, hepatic vein were observed real-time anduninterrupted. The dynamic image was storaged in the compuer connected with theultrasonic diagnostic apparatus. The appearance of ultrasound contrast agent in the lumenwas the ultrasound contrast agent arrival time. Tow experienced ultrasound doctor playedback the dynamic image independently after study. The hepatic artery arrival time（HAAT）,portal vein arrival time（PVAT），hepatic vein arrival time（HVAT）wererecorded. The interval time between hepatic artery arrival time and hepatic vein arrivaltime (VAT) and the interval time between portal vein arrival time and hepatic vein arrivaltime (VVT) were calculated. The last experimental data was average value. In themorning of the same day, the patients and healthy controls were drawed off fasting veinblood. The serum levels of HA, LN, PIIINP, IVC were determined by chemicuminesence.The contrast-enhanced ultrasound and serological tests were done on the next day afterliver biopsy. Accordinng to the liver histopathology, the changes of HAAT, PVAT, HVAT, VAT, VVT and serum fibrotic markers were observed.Results The HAAT and PVAT showed no correlation with the stage of liver fibrosis. TheHVAT, VAT, VVT decreased as the increase of liver fibrosis (P <0.05). HVAT, VAT,VVT correlated negatively with the development of fibrosis (P <0.01). The correlationcoefficient of VVT was highest（r=-0.88）. The PIIINP showed no correlation with thestage of liver fibrosis. The HA, LN, CIV increased as the increase of liver fibrosis (P<0.05). HA, LN, CIV correlated just with the development of fibrosis (P <0.01). Thecorrelation coefficient of HA was highest（r=0.54）.Conclusion (1) The stage of liver fibrosis can be evaluated by contrast pluse sequenceimaging with contrast agent.(2) HA, IVC, LN are able to assess the liver fibrosis.(3)Thecontrast-enhanced ultrasound and HA, IVC, LN can evaluate the stage of liver fibrosis.The contrast-enhanced ultrasound is closer with the stage of liver fibrosis than the secrumfibrotic makers.The contrast-enhanced ultrasound can guid the doctor to draft treatment,evaluate changes in condition and judge the prognosis more accurately than the secrumfibrotic markers.